This cross-sectional study was carried out to identify A. actinomycetemcomitans and P. intermedia in the subgingival plaque of three ethnic groups (Malays, Chinese and Indians) in a selected group of adult Malaysians with advanced Chronic Periodontitis and to correlate these findings with their periodontal status. Thirty periodontally diseased adults were age, gender and ethnically matched with 30 healthy individuals. Clinical parameters were assessed for all. Subgingival plaque samples were collected for identification of A. actinomycetemcomitans and P. intermedia using polymerase chain reaction. Prevalence for P. intermedia (83.3%) was high and A. actinomycetemcomitans (6.7%) low in the total subject population. P. intermedia and A. actinomycetemcomitans were more prevalent in diseased (86.7%, 10% respectively) than in healthy (80%, 3.33% respectively) subjects. A. actinomycetemcomitans was detected in 15% Indians, 5% Malays but none of the Chinese subjects whereas P. intermedia was detected in 90% Malays, 85% Indians and 75% Chinese subjects. No significant association between presence of A. actinomycetemcomitans and P. intermedia with race and periodontal disease status was found. Only A. actinomycetemcomitans had a significant association with clinical attachment level (CAL) (p < 0.05). In conclusion, in this small subject group, none of the pathogens were associated with race and periodontal disease status and only A. actinomycetemcomitans had a significant association with CAL.

Patients with Wellen’s syndrome often present with chest pain and found to have specific precordial T-wave changes on the electrocardiogram (ECG). They subsequently develop a large anterior wall myocardial infarction. These specific electrocardiographic abnormalities are associated with critical stenosis of the proximal left anterior descending coronary artery (LAD). This syndrome is often under-recognised and has fatal consequences; it is, therefore, also known as the widow maker. We highlight a case of a 39-year old gentleman who had a history of coronary artery disease and typical ECG characteristics of Wellen’s syndrome.
Electrocardiography ; chest pain

AIM: To evaluate the prophylactic usage of intracameral cefuroxime in the prevention of postoperative endophthalmitis (PE). METHODS: Phacoemulsification surgery of 6 099 patients with age-related cataract was studied retrospectively. In control group, 3 075 patients (3 075 eyes) had undergone surgery without use of intraocular antibiotics (IOA) between October 2001 and May 2004; and in study group 3 024 patients (3 024 eyes) had undergone the surgery with intracameral cefuroxime 1mg in 0.1mL between June 2004 and April 2007. Peroperative prophylaxis and operative procedures were the same in both groups. RESULTS: PE developed in 13 (0.42%) and 4 (0.13%) patients in the control and the study groups respectively [P=0.031;odds ratio= 3.20(1.04-9.84)]. PE developed 30 (3-75) days, and 25 (2-35) days after the surgeries in the two groups (P=0.35) respectively. Monomicrobial infections were observed. In the study group Aspergillus fumigatus and Pseudomonas aeruginosa were resistant to cefuroxime; however, Streptococcus pneumonia was sensitive to cefuroxime. No sign of toxicity or allergy from intracameral cefuroxime was noted.CONCLUSION: Intracameral prophylactic cefuroxime appears safe. It may provide considerable protection against bacterial PE; however, possibility of insufficient antibiotic coverage and antibiotic resistance of causative microorganism should be considered.